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V <br />•l <br />Public Works <br />Maintenance <br />1820 Roosevelt Blvd. <br />on 97402 <br />Location of ; '..W' <br />Wastewater Connection EugenO,• Orego <br />(541) 682-48 00 <br />Property Information ,gM (a.oS6TT^' <br />. Address -------:—:----------:—---------r-------------:------------- <br />Map and Tax Lot <br />Building Type: B SFD □ Duplex '□ Multi-iFamily □ Commercial □ Industrial <br />\ WVU Gb^CTTOwner <br />Permit Information • • • • • • <br />Permit \A •* OCP ^7 P'_______*____Date of Issue <br />Contractor/Plumber;—^_PIpe Material--------Pipe Diameter^'1 <br />□ Right of Way Cut Permit'Required □ System Development <br />1Q/ °^ ^ I ^_________ Inspected By ‘iQH <br />iharge rvWInstallation Date <br />Pvrmhstc* srvnM lo aitoch prM» —w ccnhiclfon to ptMk Mwtr h ccnformrxxK* to Oty ttoKfard* and <br />Public Wastewater .Information.. <br />Index Page .No.,-----'ns Contract No.L'ps:re<in Uawrulrearn <br />RosetrA A\)t l22.^:iA!—AO0< <br />II 110' <br />i/ c✓— <br />/n' <br />i • <br />iI <br />_i <br />21’ <br />s-1* V <br />a.' ^ <br />\\'